Page breadcrumb nav

VAERS Report 2156661

Case Report Section

Détails du rapport Vaer

Âge: 79 ans

Genre: Female

Région : Outside US

Patient décédé?
Non
Renseignements sur les vaccins

Nom: COVID19 (COVID19 (PFIZER-BIONTECH))

Type : Coronavirus 2019 vaccine

Fabricant: PFIZER

Lot: en3924


Date de réception du rapport
2022-03-04
Date à laquelle le formulaire est complèté
Date de vaccination
2021-01-29
Date d’apparition
0
Nombre de jours (date d’apparition – date de vaccination)
0
Description de l’événement indésirable

headache; rash; inflammation; clot blood; this is a spontaneous report received from a contactable reporter (consumer) from the regulatory authority. other case identifier(s): gb-mhra-adr 26651801, gb-mhra-vac-202202251018354710-oi8qm. a 79 year-old female patient received bnt162b2, administration date 29jan2021 (lot number: en3924) at the age of 79 years as dose number unknown, single for covid-19 immunisation. the patient's relevant medical history and concomitant medications were not reported. the following information was reported: headache (disability, medically significant) with onset 29jan2021, outcome "recovered", described as "headache"; rash (disability, medically significant) with onset 29jan2021, outcome "recovered", described as "rash"; inflammation (disability, medically significant) with onset 29jan2021, outcome "recovered", described as "inflammation"; thrombosis (disability, medically significant) with onset 29jan2021, outcome "recovered", described as "clot blood". the reporter did not think this reaction occurred as a result of a mistake made in the administration of the vaccine. no follow-up attempts are possible. no further information is expected

Données de laboratoire
na
Liste des symptômes
rash headache thrombosis inflammation
Patient décédé?
Non
Date de décès
N/A
Anomalie congénitale
false
Vaccin administré par :
Other
Vaccin acheté par :
Inconnu
Visite d’un patient à l’urgence?
Non
Patient hospitalisé?
Non
Séjour à l’hôpital
Non
Nombre de jours à l’hôpital
Non spécifié
Invalidité permanente?
Oui
Allergies:
na
Maladie actuelle
na